Impact on Kids' Health

November 3, 2009

Greener School Cleaning Supplies: Impact on Kids' Health

Students Face Health Risks from Air Contamination

Healthy indoor air is essential for any classroom. Yet a U.S. Department of Education survey revealed that 1 in 5 public schools in the U.S. have unsatisfactory indoor air quality, and 1 in 4 have inadequate ventilation (NCES 2007). A 2004 California Air Resources Board report on portable and traditional classrooms throughout the state found substandard levels of fresh air in classrooms during 40 percent of class hours, with seriously deficient ventilation 10 percent of the time (CARB 2004). As a result, nearly all classrooms tested contained hazardous contaminants like formaldehyde at levels above government guidelines designed to protect against cancer and other long-term health effects.

Children subjected to poor quality air at school are less healthy (Myhrvold 1996), less able to concentrate (Myhrvold 1996; Smedje 1996), and do worse on tests (Shaughnessy 2006). They also miss more days of school (Shendell 2004). A child's overall academic performance suffers with such illness or absence (Weitzman 1982; O'Neil 1985; Silverstein 2001). EPA advises schools to improve indoor air quality to increase both health and scholastic achievement (EPA 2003).

School staff should take a careful look at the cleaning supplies they use as one means of maintaining healthy air in the classroom. Some cleaners can be a significant source of indoor air pollution that harms air quality, causing asthma and other health problems in students, teachers, custodians, and staff. Chemicals in many conventional cleaning supplies used in schools in California have been linked to asthma, cancer, reproductive toxicity, hormone disruption, and neurotoxicity. After cleaning, chemical residues have been measured in air, on surfaces, in dust - and some of these chemicals have been detected in people's blood and urine, a clear indication of exposure.

Children's Asthma and Cleaning Supplies

CDC surveys have detected a dramatic increase in childhood asthma across the country in the span of just a few decades. At present, nearly 1 in 10 children (9.3 percent) has asthma in the U.S. (CDC 2008), up from 7.5 percent in 1996, and just 3.6 percent in 1980 (CDC 2006). In California, one in six children will develop asthma at some point during childhood or adolescence (Babey 2006). Childhood asthma is more common among African-American, Latino, and low income communities (CDC 2006; Babey 2007; Meng 2007). Hospitalization rates for asthma are at historically high levels, mirroring the documented trends in asthma prevalence (CDC 2006).

Childhood asthma affects education as well as health. Nationally, asthma is the leading cause of missed school days due to a chronic illness, accounting for one-third of these absences (EPA 1991). Asthma was responsible for an estimated 1.9 million missed school days in California in 2005 (Meng 2008), and approximately 14.7 million missed school days each year nationally (EPA 2005). Every school absence represents lost opportunities for learning and lost school revenue from the state. Is it possible that schools themselves may unintentionally contribute to growing rates of asthma through use of cleaning products containing ingredients known to cause asthma?

Many ingredients in conventional cleaning supplies cause asthma in previously healthy people, according to the Association of Occupational and Environmental Clinics (AOEC), the leading international body concerned with the link between chemical exposures and asthma. Examples of recognized asthmagens used in cleaning products include a class of surfactants called ethanolamines (like monoethanolamine, diethanolamine, and triethanolamine) and a class of antibacterial agents known as quaternary ammonium compounds (like benzalkonium chloride, or alkyl dimethyl benzyl ammonium chloride). More asthma-causing air contaminants specifically measured in EWG tests of cleaning supplies include formaldehyde, methyl methacrylate, and styrene. In addition, fragrances, which are common components of cleaners, are among the top five allergens in the world (de Groot 1997; Jansson 2001), and are known to trigger asthma attacks (Norback 1995; Millqvist 1996).

Several studies also conclude that both occupational and non-occupational use of cleaning products are linked to increased risk of asthma (Medina-Ramon 2005, 2006; Arif 2009; Bernstein 2009). Teachers have high levels of asthma when compared to the general workforce (NIOSH 2004; Mazurek 2008), and a recent study of California and three other states noted that many teachers specifically report exposures to cleaning supplies in association with development of work-related asthma (Mazurek 2008).

Like teachers, school children spend a large part of their day inside classrooms cleaned with chemicals that can cause or exacerbate asthma, and breathe in a complex set of indoor air contaminants with lungs that are still developing. While many children outgrow their asthma diagnosis, childhood is a time of elevated sensitivity to irritating chemicals. According to the National Academy of Sciences, one factor in children's exceptional sensitivity to the harmful effects of chemicals is that their developing organ systems are more vulnerable to damage from chemical exposures (NAS 1993). The Academy also concluded that children are less able than adults to detoxify and excrete chemicals.

In addition, a child's chemical exposures are greater pound-for-pound than those of an adult (NAS 1993). On a body weight basis, for example, a resting child breathes up to twice as much air as adults (EPA 2008) - an important factor when considering the effects of air pollution in the classroom. Finally, the National Academy of Sciences notes that children have more years of future life in which to develop disease triggered by early exposure (NAS 1993).

Green Seal, an independent group that certifies green cleaners, has taken into account children's special susceptibility to toxic air contaminants in designing its cleaning product standards (Green Seal 2008). According to the latest version of Green Seal's certification standard, certified green products are prohibited from containing ingredients classified by AOEC as both asthmagens and sensitizers.

EcoLogo, another independent green certification company, specifically prohibits a number of typical cleaning product ingredients found on the AOEC list (EcoLogo 2008). While green cleaning products generally contain far fewer asthmagens than conventional products, air contaminant tests did detect one such chemical, methyl methacrylate, in the EcoLogo-certified Waxie Green Floor Finish. This chemical is not specifically prohibited by EcoLogo criteria, suggesting that a more comprehensive prohibition of AOEC asthmagens might strengthen the EcoLogo standard and better protect public health.

Cleaning products also contribute to asthma indirectly, by releasing a host of volatile organic compounds (VOCs) that form ozone when in the presence of other widely distributed air contaminants composed of nitrogen and oxygen. Ozone is the primary component of smog that can trigger asthma. Ozone was not detected in this study because the VOCs emitted by cleaning products were exposed to purified air free of nitrogen-oxygen air contaminants. These common contaminants undoubtedly affect the air in classrooms across the U.S., providing an opportunity for ozone formation during and after use of cleaning supplies that release VOCs.

Use of cleaning products can release volatile organic compounds at levels up to 100 times higher than found outdoors; these levels can even exceed safety limits established for industrial settings (Nazaroff 2006). So many of these volatile organic compounds are capable of producing ozone that estimates of smog-forming VOCs can be made by measuring the total level of all VOCs emitted, then subtracting methane, a single nonreactive volatile compound, from this measurement.

Recent research indicates exposure to ozone can be especially harmful for children. A six-month study of fourth graders in 12 southern California communities documented an 83 percent increase in respiratory-related absences when daytime ozone levels increase by 20 parts per billion (Gilliland 2001). Children who grow up in smoggy regions have permanently scarred lungs, and feel lifelong effects of diminished lung capacity (Kunzli 1997). For this reason, certification organizations place strict limits on the levels of volatile organic compounds emitted by green cleaning products.

Volatile chemicals known as terpenes, derived from pine and citrus oil cleaners, produce another asthma risk. Terpenes can react with trace levels of ozone to form formaldehyde, an asthmagen and known human carcinogen. The California Air Resources Board recommends avoiding use of citrus and pine oil cleaners, especially on smoggy days (CARB 2008).

The annual direct medical cost of asthma in both children and adults is estimated at $37 billion nationwide (Kamble 2009). The indirect costs for an individual child are difficult to quantify, but encompass impacts on a child's education and well-being from asthma caused or triggered by cleaning products. And asthma is just one of many long-term health consequences associated with cleaning product chemicals.

Chemicals in Cleaning Supplies Raise Other Health Concerns

Individual chemicals found in cleaning products are tied to a number of other serious human health threats, according to numerous laboratory studies and, in some cases, research on exposure and disease in people.

Cancer

Increasing incidence of many childhood cancers, including leukemia, non-Hodgkins lymphoma, and specific brain and nervous system cancers (Woodruff 2004; Ries 2007), are a clear cause for concern regarding children's exposures to chemicals linked to cancer. Air pollution tests of cleaning products used in schools, along with limited ingredient disclosure, revealed a total of 11 cleaner chemicals classified as known, probable, or possible human carcinogens.

For example, Comet Disinfectant Powder Cleanser released benzene, formaldehyde, chloroform, and three more cancer-causing chemicals. An additional carcinogen, quartz, was not detected by testing, but is disclosed as an ingredient by the manufacturer. Quartz is an inhalation carcinogen. School children are unlikely to inhale quartz powder present in cleaning products, but custodians may experience more substantial exposures. The widely used graffiti remover Goof Off emitted ethylbenzene and 2-butoxyethanol, both linked to cancer.

Green Seal-certified cleaning supplies cannot contain ingredients classified as carcinogenic by the Environmental Protection Agency (EPA), the National Toxicology Program (NTP), the Occupational Safety and Health Administration (OSHA), or the International Agency for Research on Cancer (IARC). These products also cannot contain ingredients known to produce or release these carcinogenic compounds (Green Seal 2008). EcoLogo prohibits formulation or manufacture of certified green cleaning products with any carcinogens listed by IARC (EcoLogo 2008).

While 10 of 16 conventional products emitted carcinogens, just one of six certified green cleaning products, Waxie Green Floor Finish, emitted any of these cancer-causing chemicals. The chemicals emitted by this green product are specifically prohibited by the green standard it is certified to meet (EcoLogo 2007), implying an inconsistency between the manufacturer's disclosures concerning formulation and the actual chemicals released by the product. If green certifying groups required air testing results for certification, such inconsistencies could be detected and resolved immediately. That would ensure that certified green products did not emit substances prohibited by their certification standards, resulting in safer, healthier, and more trustworthy green cleaning supplies.

Carcinogenic chemicals prohibited in certified green products are released by 10 conventional cleaners, and by one green cleaner.

Carcinogen

Cleaning Product

Acetaldehyde (1,2,3)

Comet Disinfectant Powder Cleanser

Febreze Air Effects

Simple Green Concentrated Cleaner/Degreaser/Deodorizer

Waxie Green Floor Finish

Benzene (3,4,5)

Comet Disinfectant Powder Cleanser

2-Butoxyethanol (6)

Glance HC Glass and Multi-Surface Cleaner

Goof Off Cleaner (CA VOC Compliant)

Pioneer Super Cleaner

Shineline Seal Floor Sealer/Finish

Simple Green Concentrated Cleaner/Degreaser/Deodorizer

Waxie 21 Glass Cleaner

Waxie Green Floor Finish

1-Chloro-2,3-epoxypropane (1,3,7)

Comet Disinfectant Powder Cleanser

Chloroform (1,2,8)

Comet Disinfectant Powder Cleanser

Ethylbenzene (2)

Waxie 21 Glass Cleaner

N-Ethyl-N-nitroso-ethanamine (1,3,7)

Comet Disinfectant Powder Cleanser

Formaldehyde (1,4,9)

Comet Disinfectant Powder Cleanser

Pine-Sol Brand Cleaner (Original)

Pioneer Super Cleaner

Simple Green Concentrated Cleaner/Degreaser/Deodorizer

Quartz* (4)

Waxie Green Floor Finish

Styrene (2)

Shineline Seal Floor Sealer/Finish

Trichloroethylene (1,7)

Citrus-Scrub 90

*Ingredient disclosed by manufacturer but not detected in air contaminant tests

Allylanisole, a carcinogen identified in California's Proposition 65 list but not on any of the agency lists specified in existing certification standards, was detected in the conventional cleaner Simple Green. This chemical is typically extracted from plant sources and can be used as a component of fragrances at low levels, among other uses. If certification groups included Proposition 65 chemicals in their list of prohibited carcinogens, their standards could be even more health protective.

Cleaning product ingredients can also be indirect sources of carcinogenic contamination. As described above, the known human carcinogen formaldehyde can form by mixing trace amounts of ozone in the air with terpenes, natural components of pine and citrus oil cleaners like Pine-Sol. Formaldehyde formation from terpenes is higher on smoggy days when ozone levels are high.

Reproductive Toxicity

Each year, about 7.3 million American couples have trouble becoming pregnant or carrying to full term, an increase of 20 percent over the last 10 years (Barrett 2006). Alarmingly, infertility is rising most rapidly for women under age 25. Increasing evidence indicates everyday exposures to reproductive toxins may play a role in escalating levels of infertility in the U.S.

Conventional cleaning supplies can contain a number of reproductive toxins. Phthalates, common ingredients in cleaner fragrances and in some floor finishes and window cleaners (WVE 2007), are reproductive toxins according to a number of animal studies (CERHR 2000; OEHHA 2007). In addition, epidemiological studies link a number of reproductive effects to phthalate exposure, including male reproductive system abnormalities (Swan 2005), altered sex hormone levels in baby boys and men (Main 2006; Duty 2005), and sperm damage in men (Duty 2003, 2004; Hauser 2007). Dibutyl phthalate is an ingredient in Shineline Seal Floor Sealer/Finish, one of the products examined in this study.

While phthalates may be present in other cleaning products tested, especially as components of fragrance, these chemicals are not sufficiently volatile to be measured as air contaminants. Instead, phthalates released by cleaners are likely to contaminate dust (Rudel 2003; CDC 2005). Exposures to toxins in dust are significant especially for younger children who are more likely to spend time sitting or playing on the floor (Butte 2002). According to the manufacturer, Shineline Seal Floor Seal/Finish contains up to five percent dibutyl phthalate, an alarmingly high level considering the potential this creates for children’s exposure to a known reproductive toxin.

Dibutyl phthalate is a known reproductive toxin as defined by the state of California's Proposition 65 process. Other Proposition 65 reproductive toxins detected in these tests of cleaning supplies include solvents like toluene, benzene, and ethoxyethanol. These chemicals were detected in a total of four products, including one Green Seal-certified cleaner, Alpha HP. Green Seal-certified products must not contain Proposition 65 reproductive toxins as ingredients, nor can they contain ingredients known to produce or release these compounds (Green Seal 2008). In this case, testing data indicate a certified green product released trace levels of a prohibited compound, perhaps due to contamination of a product ingredient.

Other cleaner chemicals not yet listed as reproductive toxins in California are linked to reproductive harm. Glycol ethers, including the widely used 2-butoxyethanol, are common cleaning solvents that impair fertility and harm development in animal studies (EPA 2000; NTP 2000). Other studies find that men exposed to glycol ethers on the job are more likely to have reduced sperm counts, while pregnant women exposed on the job are more likely to give birth to children with birth defects (Cordier 1997; CDHS 2007). 2-Butoxyethanol was detected in six conventional cleaning products (Simple Green Concentrated Cleaner/Degreaser/Deodorizer, Glance HC Glass and Multi-Surface Cleaner, Shineline Seal Floor Sealer/Finish, Goof Off Cleaner (CA VOC Compliant), Pioneer Super Cleaner, and Waxie 21 Glass Cleaner), and one certified green product (Waxie Green Floor Finish). Only five cleaning products (Citrus-Scrub 90, Comet Disinfectant Powder Cleanser, Glance NA Glass & Multi-Purpose Cleaner, Marauder Environmental Cleaner, and NABC Non-Acid Disinfectant Bathroom Cleaner) were free of all glycol ethers examined by laboratory tests.

Quaternary ammonium compounds (quats) are antibacterial pesticides commonly used in disinfectants. A quat-based disinfectant called Virex, similar to one used in multiple school districts in California, was recently identified by noted scientist Dr. Patricia Hunt as the cause of a severe decline in the fertility of a laboratory mouse population -- preliminary evidence that quats may be reproductive toxins (Hunt 2008). Two disinfectants in this study, NABC Non-Acid Disinfectant Bathroom Cleaner and Virex II 256, both list quats as ingredients. Quats may be present in other products as well, as they are also used for their detergent properties. These chemicals are non-volatile and are expected to contaminate dust (Ferrer 2002). EcoLogo certified products are prohibited from containing quats.

For some certified green cleaning supplies, state-of-the-art air quality tests again highlight a discrepancy between ingredients disclosed to green certifiers and air contaminants emitted by these products. By requiring independent air contaminant testing as part of certification, Green Seal and EcoLogo would be able to verify that certified green products are free of many prohibited reproductive toxins, guaranteeing safer products.

Hormone Disruption

Signs of hormone disruption are evident in girls growing up all over America. Over the last four decades, the age at which girls begin to develop breasts has declined by one-to-two years (Steingraber 2007), with African-American girls typically developing at an earlier age than Caucasian girls. Over the same 40-year period, the age at which girls in the U.S. begin menstruating has declined by a few months, with substantial variation by ethnicity (Steingraber 2007). Early breast development, as well as the appearance of pubic hair at a young age, has become so common that in 1999 the clinical definition of early-onset or precocious puberty in the U.S. was reduced from age 8 to age 7 for Caucasian girls, and from age 7 to age 6 for African-American girls (Kaplowitz 1999).

Early-maturing girls are also more prone to a variety of psychiatric or behavioral problems, from depression to drug abuse and teen pregnancy (Graber 1997, 2004; Kaltiala-Heino 2001, 2003a, 2003b; Flanigan 2003; Deardorff 2005). Women experiencing early puberty tend to have less education (Johansson 2005), while late-maturing girls tend to perform better in school and are more likely to finish college (Graber 1997, 2004).

Scientists and medical professionals increasingly identify exposures to hormone-disrupting chemicals as a significant factor in unnaturally accelerating this critical period of development. Preliminary research on people suggests that exposures to one particular class of hormone-disrupting chemicals, phthalates, may be linked to early puberty in girls (Colon 2000).

Dibutyl phthalate and other phthalates are common ingredients in cleaning products and have well-documented hormone disrupting properties, according to laboratory tests and epidemiological studies (ATSDR 1995, 1997; CERHR 2000; Main 2006; Duty 2005; Huang 2007; Meeker 2007). Alkylphenols, breakdown products of widely used alkylphenol ethoxylate cleaner ingredients like nonyl phenol ethoxylate, are widely-acknowledged hormone disruptors implicated in the feminization of fish living in waterways receiving treated wastewater (Balch 2006; Zoller 2006; Barber 2007). Fragrances used in many cleaners can contain known or suspected hormone disruptors as well (EWG 2008).

Groups certifying green cleaning products have different ways of addressing hormone-disrupting chemicals. EcoLogo-certified products may not include chemicals listed in 2000 by the European Commission as candidates for evaluation of hormone-disrupting properties (European Commission DG ENV 2000), a list drawn from the rapidly emerging science on this critical health and environmental concern. However, phenol and ethylene glycol, two chemicals detected in these tests of cleaning product pollution, have been added to an updated version of this European list that is not included in the EcoLogo standard (European Commission DG ENV 2007). The Green Seal certification standard prohibits a few specific chemical classes, including phthalates and alkylphenol ethoxylates, due to hormone disruption concerns. By prohibiting a more up-to-date list of hormone-disrupting chemicals, EcoLogo and Green Seal could further improve product safety.

Hormone disruptors, some specifically prohibited in certified green products, are released by many cleaners.

* Chemicals disclosed as ingredients by manufacturers but not detected in air contaminant tests

** Potential hormone disruptors mentioned in the most recent European Comission candidate list, and not prohibited by the EcoLogo standard (EC 2007, EcoLogo CCD-146, 2008)

Neurotoxicity and Developmental Disabilities

In light of recent warnings suggesting that developmental disabilities stemming from exposures to neurotoxic chemicals may be a "silent pandemic in modern society" (Grandjean 2006), children require special protection from neurotoxins. Growth and development of the brain continues for many years after birth, leaving children uniquely sensitive to the effects of neurotoxic agents; in particular, dramatic changes to brain structure and function occur during adolescence (Golub 2000).

Examples of neurotoxins commonly used in cleaning products are benzyl and isopropyl alcohol, detected in NABC Non-Acid Disinfectant Bathroom Cleaner, Waxie 21 Glass Cleaner, and Ripsaw; isopropyl alcohol is also a known ingredient of Pine-Sol Original Cleaner. Although limits have been set for these chemicals in food, no limits are in place for cleaners.

A number of chemicals that incorporate chlorine are toxic to the brain and nervous system. Xylene is a neurotoxic component of certain heavy duty cleaning supplies, like Goof Off Cleaner (CA VOC Compliant) and Shineline Seal Floor Sealer/Finish, which are in use in California schools. Toluene and chloroform, both emitted by Comet Disinfectant Powder Cleanser, are also neurotoxic chemicals. Fragrances used in many cleaning products can contain ingredients suspected of neurotoxicity as well (USHR 1986).

Health-based limits exist regarding exposure to many neurotoxins in the workplace. These exposure limits, however, were designed only to protect against acute effects such as headache, and have not been tightened in decades despite recent scientific evidence of potential health effects of chronic, low-dose occupational exposures.

Neurotoxins are released by cleaning products, according to air contaminant tests and ingredient disclosures

Neurotoxin:

Cleaning Product:

Acetone*

Goof Off Cleaner (CA VOC Compliant)

Benzene

Comet Disinfectant Powder Cleanser

Benzonitrile

Comet Disinfectant Powder Cleanser

Benzyl Alcohol

Ripsaw

Chloroform

Comet Disinfectant Powder Cleanser

Cyclohexanone

3M Brand Bathroom Cleaner (Product No. 44, Twist 'n Fill System)

Virex II 256

Dibutyl phthalate*

Shineline Seal Floor Sealer/Finish

N,N-Dimethylformamide

Clorox Regular Bleach

Goof Off Cleaner (CA VOC Compliant)

Ethyl acetate

Febreze Air Effects

Isopropyl alcohol

NABC Non-Acid Disinfectant Bathroom Cleaner

Pine-Sol Brand Cleaner (Original)*

Ripsaw

Waxie 21 Glass Cleaner

Methyl ethyl ketone

Comet Disinfectant Powder Cleanser

Methyl methacrylate

Waxie Green Floor Finish

Phenol

Simple Green Concentrated Cleaner/Degreaser/Deodorizer

Styrene

Shineline Seal Floor Sealer/Finish

Toluene

Alpha HP Multi-Surface Cleaner

Comet Disinfectant Powder Cleanser

Goof Off Cleaner (CA VOC Compliant)

Trichloroethylene

Citrus-Scrub 90

Xylene

Goof Off Cleaner (CA VOC Compliant)

Shineline Seal Floor Sealer/Finish

Source: Chemicals known to be neurotoxic according to Grandjean 2006.

* Chemicals disclosed as ingredients by manufacturers but not detected in air contaminant tests

Cleaning Products Pose Risks to School Custodians, Too

The custodial and operations staff working each day to provide California's children with a sanitary school environment receive the brunt of exposures to harmful chemicals in cleaning products. Cleaning professionals suffer a number of serious chemical injuries on the job. For example, 6 out of 100 janitors in Santa Clara County, California experience chemical-related injuries annually; 20 percent of these injuries are serious burns to the eyes or skin (Barron 1999).

Custodial staff experience increased incidence of asthma compared to those in other occupations (Zock 2001; NIOSH 2004; Medina-Ramon 2005; Jaakkola 2006). A recent study of work-related asthma in four states indicates that 12 percent of cases are associated with exposure to cleaning products (Rosenman 2003). Twenty two percent of those afflicted worked as janitors, and 13 percent worked in schools. Use of cleaning products can also exacerbate existing asthma; a recent study of asthmatic women who clean their own homes indicated increased asthma symptoms after housecleaning (Bernstein 2009). Across the state of California, asthma is responsible for an estimated 2 million days of missed work (Meng 2008), an indication of the severity of this public health crisis.